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Flaw In Emergency Response System May Have Killed Hundreds

timothy posted more than 4 years ago | from the problem-with-algorithms dept.

Communications 437

Hugh Pickens writes "The Telegraph reports that a flaw in the way emergency response software was set up to handle Category A responses in Great Britain may have cost hundreds of lives over the past ten years. Most ambulance services use an international computerized system designed in America and in the US version, a fall of more than 6 feet receives the maximum priority response. However, the government committee which governs its use in Great Britain decided that such cases should be deemed less urgent, and excluded from an eight minute category A target response time. If a call involved a fall of more than 6 feet it was designated a lower priority 'category B response' despite the presence of life-threatening conditions which were supposed to receive the most urgent category A response. The flaw came to light after Bonnie Mason, 58, fell 12 feet down the stairs and died from a head injury after emergency controllers in Suffolk failed to identify her situation as 'life-threatening.'"

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More like a flaw in statistics (4, Informative)

selven (1556643) | more than 4 years ago | (#31562066)

The summary sounds like "we underestimated how dangerous a medium distance fall can be, so we didn't have the correct priorities and more people died than could have". That isn't really a flaw in the algorithm, it's just a flaw in one specific parameter in the algorithm.

Re:More like a flaw in statistics (-1, Flamebait)

Anonymous Coward | more than 4 years ago | (#31562122)

The point is this: the software was written in the USA, and it murdered peaceful and enlightened Europeans.

Re:More like a flaw in statistics (4, Insightful)

Anonymous Coward | more than 4 years ago | (#31562236)

The British aren't really Europeans. Socially, they're much more like Americans than they are like those from the Continent.

Re:More like a flaw in statistics (-1, Flamebait)

Anonymous Coward | more than 4 years ago | (#31562352)

Yanks have our own continent (without British interruption), thanks.

Re:More like a flaw in statistics (2, Interesting)

Anonymous Coward | more than 4 years ago | (#31562446)

Nice FUD there... but actually, the British selected a lower category than the default for that situation, according to the summary.

Note:

Most ambulance services use an international computerized system designed in America and in the US version, a fall of more than 6 feet receives the maximum priority response. However, the government committee which governs its use in Great Britain decided that such cases should be deemed less urgent, and excluded from an eight minute category A target response time.

Also, to the GGGP, TFA states that the fine tuned algorithm was supposed to invoke additional training for ambulance staff to elevate issues manually if life-threatening conditions were detected. In any case, I'm confused on how they would do that as, by my understanding, the categorisation determines response time which would delay the initial response... hardly giving them a chance to upgrade the category of the incident. But hey, I didn't read it that thoroughly, so correct me if I missed something.

Re:More like a flaw in statistics (0)

Anonymous Coward | more than 4 years ago | (#31562360)

Oui, you must be French!

Re:More like a flaw in statistics (5, Insightful)

Anonymous Coward | more than 4 years ago | (#31562394)

The point is this: the software was written in the USA, and it murdered peaceful and enlightened Europeans.

The point is actually this: the software was written in the USA, but the Europeans had to go and dick with it thereby murdering the people that elected the retards who decided to perform the aforementioned dickery.

Re:More like a flaw in statistics (2, Interesting)

Anonymous Coward | more than 4 years ago | (#31562134)

It is worse than that actually. The operators were prohibited in upgrading the priority manually. The emergency services just trusted the computer program.

Re:More like a flaw in statistics (-1, Troll)

Anonymous Coward | more than 4 years ago | (#31562150)

The flaw came to light after Bonnie Mason, 58, fell 12 feet down the stairs and died from a head injury

"I've fallen...and I can't get up!"

But seriously - she was gonna die soon anyway. She probably nagged the hell out of her family and held up supermarket lines arguing with the cashier over a 5-pence rebate.

Re:More like a flaw in statistics (5, Insightful)

Anonymous Coward | more than 4 years ago | (#31562186)

It seems that the software downgraded to category B if the fall was larger than 6 feet regardless of other (category A) factors.

e.g., the patient has been shot and stabbed and drowned and fell 8 feet so it's a category B now.

That is a fault in the software.

Re:More like a flaw in statistics (1, Insightful)

Anonymous Coward | more than 4 years ago | (#31562670)

The software worked fine until the government committee fucked with it. These people are bureaucrats, not doctors, not programmers, this change was undoubtedly necessary only to justify the continued employment of these otherwise useless people.

The software was fine, the fault was with the government. ... and perhaps a small amount for the emergency controllers who didn't recognize an urgent situation when they heard one, regardless of what the computer was telling them. It is also possible that the software wouldn't let them override the automatic priority, the summary didn't say, which I would point back at that committee until proven otherwise.

Re:More like a flaw in statistics (1)

brunokummel (664267) | more than 4 years ago | (#31562798)

It seems that the software downgraded to category B if the fall was larger than 6 feet regardless of other (category A) factors.

e.g., the patient has been shot and stabbed and drowned and fell 8 feet so it's a category B now.

That is a fault in the software.

So it's simple to fix it. Just insert another question: "Is the person well ? Is he begging for his life? or does he look like he's dead?"

Re:More like a flaw in statistics (4, Insightful)

Dunbal (464142) | more than 4 years ago | (#31562212)

The summary sounds like "we underestimated how dangerous a medium distance fall can be

      Obviously the committee didn't include anyone with medical training. I am a physician and we know that even falling your own height can produce life-threatening injuries. But of course why should a government committee do anything as mundane as seek professional medical advice?

Re:More like a flaw in statistics (1)

nomadic (141991) | more than 4 years ago | (#31562504)

Obviously the committee didn't include anyone with medical training.

I don't think that's obvious at all. I would guess the committee did include such doctors, but it's possible none of them had sufficient training in trauma response. Or maybe they're just incompetent. There ARE incompetent physicians you know, in fact if you're a physician I'm sure you've run into some.

Re:More like a flaw in statistics (2, Funny)

nschubach (922175) | more than 4 years ago | (#31562598)

Either that or they put a bunch of bureaucrats and accountants in control of the money and they needed a measure to determine how to spend said money... you know, the stuff they keep telling us won't happen.

Re:More like a flaw in statistics (2, Informative)

baegucb (18706) | more than 4 years ago | (#31562684)

Seems this committee might be relevant, and if you check the 2nd link in Google, there are quite a few doctors on it:
http://www.google.com/#hl=en&source=hp&q=%22department+of+health%22+great+britain+ambulance+committee&btnG=Google+Search&aq=f&aqi=&aql=&oq=%22department+of+health%22+great+britain+ambulance+committee&gs_rfai=&fp=ae8f9588018abe0f [google.com]

Perhaps there are other factors or committees involved who ignored medical advice.

Re:More like a flaw in statistics (-1, Troll)

xetovss (17621) | more than 4 years ago | (#31562224)

There is an important lesson to be learned here. In the UK they have a near completely socialized health care system which involves rationing of the health care. Some bureaucrat somewhere in London decided it was not a priority to deem such falls as non serious which lead to the death of her. If the current Obamacare plan passes in the US, this will start to happen much more often in the US as people deemed too much of a risk or a "low" chance of survival will be put to a lower priority. I know the US Congress members that are pro Obamacare and Obama himself say this will not happen, but it is what we have to look forward to if and when Obamacare becomes law.

Re:More like a flaw in statistics (4, Insightful)

Anonymous Coward | more than 4 years ago | (#31562294)

This is not a issue with socialised medicine, Its an issue with bureaucrats not listening to the experts. Same kind of thing would happen if medical care was completely privatised.

Re:More like a flaw in statistics (1)

deniable (76198) | more than 4 years ago | (#31562310)

It's good to see you people beat the twenty minute response window. If only your ambulances were as good.

Re:More like a flaw in statistics (4, Insightful)

Anonymous Coward | more than 4 years ago | (#31562312)

And yet, the 'rationed' socialist healthcare here in Britain is still a metric fuckton better than what you get in the US.

There is an important lesson to be learned- some people really are so stupid that they'll believe ridiculous scaremongering rather than risk having to re-examine their exiting ideology.

Re:More like a flaw in statistics (0)

Anonymous Coward | more than 4 years ago | (#31562472)

... rather than risk having to re-examine their exiting ideology.

Stage right?

Re:More like a flaw in statistics (1)

dugjohnson (920519) | more than 4 years ago | (#31562514)


In the U.S. we don't measure in "metric fucktons".  We screw up in U.S. fucktons.  Also, in Britain isn't it metric fucktonnes?  Just asking.
Stosh

Re:More like a flaw in statistics (3, Interesting)

0123456 (636235) | more than 4 years ago | (#31562642)

And yet, the 'rationed' socialist healthcare here in Britain is still a metric fuckton better than what you get in the US

How strange. When I was living in the UK there always seemed to be some kid on TV looking for money to pay for them to fly to America to get treatment which they couldn't get under the rationed socialist NHS.

Re:More like a flaw in statistics (1)

Nimey (114278) | more than 4 years ago | (#31562796)

Cite?

Re:More like a flaw in statistics (0)

Anonymous Coward | more than 4 years ago | (#31562328)

Better a priority on injury than a price on life.

Re:More like a flaw in statistics (5, Informative)

jo_ham (604554) | more than 4 years ago | (#31562424)

Alternatively, we could have a US system, where the ambulance won't set off unless your insurance covers it, or won't take you to the nearest hospital because that is not "in network".

Or, they'll take you to the hospital, unconscious, and then stick you with the bill because the trip wasn't "pre-approved".

This has nothing to do with socialised care and everything to do with bureaucrats making decisions that affect people - it's is not exclusive to socialised medicine. Regardless of how you slice it, ambulances and ambulance crews are a finite resource and priorities have to be set. They should not be set by non-medical people though, as in this case which was clearly wrong, and in the case of a lot of medical decisions under the US system (where your insurance company, and not a doctor, decides the care you receive).

I'll take the NHS any day.

Re:More like a flaw in statistics (5, Informative)

SUB7IME (604466) | more than 4 years ago | (#31562462)

Just replying so that people know not to take your post literally. Ambulances in the US will take you to the nearest hospital with appropriate facilities for your condition.

Re:More like a flaw in statistics (2, Informative)

Anpheus (908711) | more than 4 years ago | (#31562484)

Your insurance company however, can still do ridiculous things to you if you were taken to a provider they don't cover, etc.

Re:More like a flaw in statistics (3, Insightful)

Anonymous Coward | more than 4 years ago | (#31562494)

Don't be surprised - accurate information about the US has never been a priority in Europe.

Re:More like a flaw in statistics (1)

Gerzel (240421) | more than 4 years ago | (#31562678)

Nor the other way round. In fact accurate information has always been secondary to ideal information.

Re:More like a flaw in statistics (1)

jo_ham (604554) | more than 4 years ago | (#31562570)

Oh I know, I should have added a (/generalisation) tag - I know a US ambulance will take you to the closest ER, but the GP's description of how this one flaw (that happened a year ago, and was fixed last year, months before the article) shows what would happen if "Obamacare" passes is just senseless hyperbole.

There are a great deal of things wrong with the US system, but my post was (mostly) hyperbole of my own.

Re:More like a flaw in statistics (0)

Anonymous Coward | more than 4 years ago | (#31562572)

It's currently fashionable to mock the US health care system.

We have a CRISIS and we must do something NOW, NOW, NOW! Obama told me so.

All hail the Obamassiah!

Re:More like a flaw in statistics (1)

nschubach (922175) | more than 4 years ago | (#31562632)

Last time I had a ride in an ambulance nobody asked me if I had insurance... only what hospital was preferred.

Re:More like a flaw in statistics (1)

jo_ham (604554) | more than 4 years ago | (#31562768)

When you ride in one in the UK, you know you will never have to worry about paying for it (or any of the treatment you receive when you arrive at your destination).

Re:More like a flaw in statistics (0)

Anonymous Coward | more than 4 years ago | (#31562656)

Or you could have a system like Canada, where the healthcare is free, but the ambulance ride isn't. And you could wait 13+ hours in a hospital to have a doctor (ANY doctor) diagnose possibly life-threatening injuries, such as chest pains.

I'll take the US system anyday. At least there you can get decent healthcare if you have the money. Here, you can't get decent healthcare, peroid.

BTW: There's a reason why British teeth are infamously ugly. NHS covers dentistry.

Re:More like a flaw in statistics (3, Informative)

twostix (1277166) | more than 4 years ago | (#31562698)

I hate to break it to you but the NHS is the worst of all the western public healthcare systems.

I'll take the Australian, German or French system any day over the abomination that is the NHS.

And I'm sure that you're aware that most states in the US (which of course are as populous and economically large as most European countries) have various forms of public insurance and public public care, so much so that even the "worst case" "victims" the administration keep bringing out to show how awful the current US healthcare system is have all been covered and receiving full treatment in their respective states public systems. Something the administration always conveniently neglect to mention.

The current rigmarole in the United States regarding healthcare is not about public / private, it's about the Federal Government moving into areas that it's does not have the authority to legislate. It's directly comparable to if (when) the European Union decides it's going to "take over" all of its member states discrete healthcare systems and run them from Brussels.

When that happens the EU *certainly* won't choose the UK model, and given how noisy and condescending you Brits have been about the Americans unwillingness to allow complete take over of healthcare by their Federal government don't expect any sympathy when the EU (yes they are talking about it http://ec.europa.eu/health/ph_overview/co_operation/mobility/patient_mobility_en.htm [europa.eu] ) comes to take over yours.

Re:More like a flaw in statistics (0)

Anonymous Coward | more than 4 years ago | (#31562258)

Not exactly. Mortality rates for different injuries are easily obtained.

Someone likely made a conscious decision to downgrade the priority of these types of falls. Whatever the reason was, it was a flawed.

Head injuries are the most sinister because it can be so difficult to diagnose the severity of the injury. Subdural hematomas, contusions and concussions can all present similarly and yet they can all have very different consequences. A concussion, statistically, is far less lethal than an acute subdural hematoma and yet a ERS dispatcher is not qualified to identify which falls might have resulted in which injuries.

Statistics, not politics, should lead emergency response systems.

Re:More like a flaw in statistics (1)

jythie (914043) | more than 4 years ago | (#31562512)

I would not even call this a flaw in a 'parameter' but in government process of assigning priorities. Bureaucracy kills again.

Re:More like a flaw in statistics (0)

Anonymous Coward | more than 4 years ago | (#31562646)

Read the article: it clearly says the problem was that the software downgraded all calls involving a 6+ ft fall, despite of other life-threatening. While it isn't clear whenever this was a bug or a configuration error, it sounds like the new version had to work around the problem rather than fix it which would indicate a bug.

Also, operators should normally have upgraded the call but in 5 of the 12 services they were specifically told not to do so.

Not a flaw in the system (5, Insightful)

Raptoer (984438) | more than 4 years ago | (#31562086)

The system itself wasn't flawed, but rather whoever set it up decided that they should be category B. The system did exactly what it was told, it just was told to do something different than in the US, and something that was later deemed to be suboptimal.

Re:Not a flaw in the system (5, Insightful)

sunderland56 (621843) | more than 4 years ago | (#31562152)

In other words - programmers can do brilliant things, only to have them screwed up royally by management.

Re:Not a flaw in the system (1)

clarkkent09 (1104833) | more than 4 years ago | (#31562568)

And if the management is a government committee, royally is an understatement.

Re:Not a flaw in the system (1)

dazjorz (1312303) | more than 4 years ago | (#31562154)

If a call involved a fall of more than 6 feet it was designated a lower priority 'category B response' despite the presence of life-threatening conditions which were supposed to receive the most urgent category A response.

Even if other factors should have given the situation an A level, it would be B because the fall wasn't "high enough". That's the flaw in the system here, if I understand the article correctly.

Re:Not a flaw in the system (0)

Anonymous Coward | more than 4 years ago | (#31562788)

Close but not quite

The system said OVER six feet is category B and UNDER six feet is category A

What they are saying is you have fallen over 6 feet and are probably stuffed (all but dead) so it is better to prioritise on someone who can be saved

Crude, rude and very effective although I would have thought stairs would be a mitigating factor (along with soft ground)

Re:Not a flaw in the system (4, Funny)

tsstahl (812393) | more than 4 years ago | (#31562222)

Mod parent up. What we should be reading is a headline that says Great Britain Death Panel Doing Bang Up Job.

Re:Not a flaw in the system (0)

Anonymous Coward | more than 4 years ago | (#31562326)

I think it should be: Great Britain Death Panel Doing Knock Out Job.

Re:Not a flaw in the system (2, Interesting)

MWoody (222806) | more than 4 years ago | (#31562228)

I know this is Slashdot and all, but for the rest of the world, "system" means any organized collection of rules and doctrines. "System" here refers to the Emergency Response System as a whole, including the computers, the people who run them, the officials responsible for determining policy, etc.

Re:Not a flaw in the system (0)

Anonymous Coward | more than 4 years ago | (#31562406)

Garbage In Garbage Out

I don't understand (5, Insightful)

zappepcs (820751) | more than 4 years ago | (#31562090)

How is this a flaw in the Emergency Response System if the change initiated by a government committee is how the incidents were classified wrongly?

Re:I don't understand (2, Insightful)

petermgreen (876956) | more than 4 years ago | (#31562162)

The article is a bit vauge but my reading of it is the flaw was that the system along with instructions given to staff combined to give a situation where the response was detemined by something other than the worst thing the staff member was told about.

That is someone with just the fall should have been class B but someone with the fall AND other issues could get misclasified as class B when they should have got a higher class from one of the other issues (in this case the person was unconscious and had breathing problems).

Re:I don't understand (0)

Anonymous Coward | more than 4 years ago | (#31562348)

Yeah, that's basically it. I know a little about AMPDS, and the idea is that with any life-threatening problem, the response should be upgraded to a Cat A (P1, whatever) job. What seems to have happened, is that instead of making a fall > 6ft a Cat B call unless there are other life-threatening symptoms (decreased level of consciousness, abnormal breathing etc), the designers cocked up and made the algorithm override all "Fall >6ft" to a Cat B call, hence lower priority. So if you'd rang for an ambulance, and not mentioned the fall bit, she would have got a Cat A response. The override was recently used in my country during the swine flu outbreak, and a few people died there, with incorrect priority assigned. Anyway, there is the Swansea AMPDS codes (with the Govt Standard also listed) http://www.sufr.co.uk/Initial_Actions/ampdsv_11.3.htm [sufr.co.uk] -- you can see there that Fall >6ft is assigned amber (Cat B).

Re:I don't understand (0)

Anonymous Coward | more than 4 years ago | (#31562216)

The flaw in the decision system was that the decision system had been told to decide in a way which wasn't the best way. As a consequences, the decision system decided in a way that wasn't the best. Where exactly the flaw lies is up to your interpretation.

Dangers of technical rationality (4, Insightful)

Geof (153857) | more than 4 years ago | (#31562264)

How is this a flaw in the Emergency Response System if the change initiated by a government committee is how the incidents were classified wrongly?

You're right: it isn't a flaw in the software per se, and I would not assign any blame to those who developed it (as opposed to those who implemented it).

However, it is a predictable of administration, and the use of information technology is often integrated into systems in just this way. The idea that risk can be rationalized and reduced to a number (class A, class B, and so on) is itself potentially dangerous. Though it is not necessarily dangerous in any particular situation, it is nevertheless predictable that administrative or technical rationality would make this kind of outcome more common.

You see, the problem was not simply that the response categories were incorrect. The problem was that the system (including its operators, operating procedures, and so on) was too rigid, too rationalized, and therefore unable to respond to unexpected events:

While some services spotted the risk, ordering operatives to override the computer's orders manually, five of England's 12 ambulance trusts did not allow call handlers to upgrade such calls.

This kind of event was clearly unexpected by the systems implementors. But even if they had assessed the danger of falls differently, there is likely some other event that would fall outside the systems parameters. (Most falls probably should be category B events, not category A.) That's why you want to have human judgement and human overrides.

Treating a system in terms of independent technical components has a number of benefits, including efficiency. That's what happened here. The process was rationally divided into tasks for the humans and tasks for the computer. Nice, neat, clean: and likely to produce outcomes like this.

Re:Dangers of technical rationality (2, Informative)

Anpheus (908711) | more than 4 years ago | (#31562564)

There is an inherent risk to allowing operators of software to override the systems rules.

I like to call it the "Red Exclamation Point Problem" or the "High Priority Problem." To a not insignificant portion of the population, opportunity to elevate, upgrade, bold, underline, highlight, or change the font red is taken at nearly every opportunity. This defeats the priority system that was set out with the intention of reducing costs, and in this case, saving more lives by better prioritizing the use of a finite resource in emergencies.

While I agree there are a number of industries and professions in which not allowing user intervention is mistaken, and while I agree that the administration who altered the system in place poorly are at least somewhat to blame for the needless deaths, I don't think dispatchers should have the ability to arbitrarily override the priority system either. It looks like the software handled everything it was told to do correctly, but the administrators made a mistake in designing and testing alterations to it and perhaps did not even consult medical professionals. As a result, people died.

And lastly, the problem isn't that most falls should probably be category B. That's already taken care of, but falls over six feet being category A must have made sense to someone, and apparently it cost lives changing it.

Re:Dangers of technical rationality (1)

MichaelSmith (789609) | more than 4 years ago | (#31562590)

The idea that risk can be rationalized and reduced to a number (class A, class B, and so on) is itself potentially dangerous

Of course. A two metre fall on to my feet would do little or no damage to me. A fall on to my head on the other hand would do a lot of damage.

A plumber I had working at my place fell three metres on to his feet but the salient point I passed to the ambulance operator was that he wanted to sit up but experienced great pain when he tried.

Oh my stars (1)

Tablizer (95088) | more than 4 years ago | (#31562114)

in Great Britain may have cost hundreds of lives over the past ten years. Most ambulance services use an international computerized system designed in America

Revenge for that Mars probe metric conversion mishap

Carol Beer was not a Satire (4, Funny)

ObsessiveMathsFreak (773371) | more than 4 years ago | (#31562142)

Caller: Please hurry!! He's fallen down a 30ft well! Can't you get here any faster!?

A&E Drone: *clackety clackety* ...... Computer say Nooooo....

Re:Carol Beer was not a Satire (4, Insightful)

TubeSteak (669689) | more than 4 years ago | (#31562668)

Caller: Please hurry!! He's fallen down a 30ft well! Can't you get here any faster!?

A&E Drone: *clackety clackety* ...... Computer say Nooooo....

Caller: Well then I'm going to get my gun and put him out of his misery.

/If that doesn't bump you up to the highest priority, nothing will.

If they're fags I don't care. (-1, Troll)

Anonymous Coward | more than 4 years ago | (#31562168)

Fags need to die. They're a drain on society.

Down with Fags! Down with Fags!

But falling 12 feet down the stairs... (0)

Anonymous Coward | more than 4 years ago | (#31562190)

is more like falling 24 times 6 inches, right?

Ambulance Service (2, Interesting)

lymond01 (314120) | more than 4 years ago | (#31562200)

We have friends in England and one of them had her hip replaced. A couple weeks after she was able to walk on it, she was doing the dishes and the replacement broke -- basically either the hip or femur end broke and was completely out of socket. Her husband called 999 and the ambulance at first refused to come because it wasn't a life-threatening emergency. "Can she just walk to the car?" "Can you carry her to the car?" You can probably imagine your wife screaming in pain, you not knowing if some vein or artery has been sliced, and any movement at all just makes her scream more. "Yah, it's cool. I just duct taped her mouth and threw her over my shoulder. I think she's passed out from the pain so tossing her in the back seat should work a treat. We'll be at the hospital in no time!"

I realize a line needs to be drawn somewhere. Some people will call for an ambulance when they've cut themselves shaving. But you know, when you can hear the screams in the background...you should probably get off your asses and help out.

Re:Ambulance Service (1)

jo_ham (604554) | more than 4 years ago | (#31562470)

If that actually happened as described, then the dispatch centre was grossly negligent, or the information provided by the person calling initially led the dispatcher to determine that it was non-life threatening.

Regardless, ambulances are routinely dispatched for non-deadly situations - which is the point of the categorisation that led to this article in the first place. Alternatively you can phone your GP and arrange an emergency home visit from whoever is on call for that, out of hours.

Re:Ambulance Service (2, Interesting)

Cassini2 (956052) | more than 4 years ago | (#31562554)

Her husband called 999 and the ambulance at first refused to come because it wasn't a life-threatening emergency.

I must be missing something here. Where I live, if you call for an ambulance, it comes. If something serious is going on, call the fire department and the ambulance, because the fire department has a quicker response time. There is no option for "not show up". Some injuries (like concussions) don't look like emergencies immediately. As such, the procedure is to get you to the hospital, and have the nurses and doctor's deal with the situation.

Sure, if you call an ambulance over a stubbed toe, then the ambulance guys will send you a bill for the ride to the hospital, and the police might charge you for wasting everyone's time. However, the ambulance, police and fire will show up.

Do the ambulances in England have an option to refuse to come in an acute, emergency situation? involving major fractures? dislocations?

Re:Ambulance Service (-1, Troll)

0123456 (636235) | more than 4 years ago | (#31562732)

Do the ambulances in England have an option to refuse to come in an acute, emergency situation? involving major fractures? dislocations?

It's called rationing, which is what happens when you have 'free' socialist healthcare and don't charge people who call for an ambulance because they're drunk and don't want to walk home.

Re:Ambulance Service (1)

Antique Geekmeister (740220) | more than 4 years ago | (#31562628)

Actually, hip fractures are quite common for old people. They often break when the person is standing up from a sitting position, which used to be mis-diagnosed as "fell when getting up". Some of the relevant data is described at http://www.pnas.org/content/102/41/14819.abstract [pnas.org] . And from experience with some old relatives, as long as they're splinted and the leg supported in the most comfortable position for that person, it's quite surprising how calm they can be about it. So I suspect that "hearing the screaming" wasn't happening.

_Moving_ them and bouncing around the fractured joint, especially if you're not careful, strong, and knowledgeable can cause an amazing amount of pain and damage. I've watched an ambulance crew moving an old relative from their nursing home to a hospital for a broken hip, and it was clearly awkward, but the relative wasn't in constant pain nor were they shouting except when being moved. They also did have a new hip joint implanted very quickly, and had years more of reasonable life.

Government committee (1)

Nidi62 (1525137) | more than 4 years ago | (#31562202)

"However, the government committee which governs its use in Great Britain decided that such cases should be deemed less urgent, and excluded from an eight minute category A target response time." I just have to wonder, what was the make-up of this committee? Was it bureaucrats, or actual medical and emergency response professionals, or a combination of the two? What was the justification and evidence used to determine the likelihood of cases such as these to be life-threatening? If I lived in England, I would be calling for all of this to be reviewed.

Re:Government committee (1)

Plekto (1018050) | more than 4 years ago | (#31562722)

What was the justification and evidence used to determine the likelihood of cases such as these to be life-threatening?

My guess is that they might have mistakenly thought it was meters instead of feet. Because a fall of more than 6 *meters* would likely have already been fatal. Every other possible explanation aside from the original posting being wrong(distinct possibility - it seems as if Slashdot's editors are nearly useless at pre-checking even basic facts lately).

The point (5, Insightful)

kdcttg (980465) | more than 4 years ago | (#31562220)

I think that the comments I have read above me are missing the point, or maybe I am.

The software was changed so that falls of more than 6 feet no longer caused a case to be considered "category A", the problem is that (through a mistake when rewriting that bit of code I assume), mention of a fall was causing a case to be considered "category B" even if other things were present that would normally have made it "category A".

Re:The point (2, Insightful)

socsoc (1116769) | more than 4 years ago | (#31562266)

I'm with you... I am thoroughly confused about the newsworthiness of this aside from that Hugh Pickens submits tons of stories.

Government Committees, I need more please (1, Insightful)

Anonymous Coward | more than 4 years ago | (#31562246)

We should have them run our healthcare in the USA!

Corporate committees are already killing children (0, Offtopic)

copponex (13876) | more than 4 years ago | (#31562384)

People need to realize that there is a corporate executive who often stands between a patient and his or her doctor. That’s the reality. And I think the insurance industry is now fear-mongering during this debate on health care reform, saying that a government bureaucrat could stand between someone and his or her doctor. But the current situation is just as bad, if not worse, because you have people doing that now who are denying care to meet Wall Street’s expectations.

Wendell Potter is former head of corporate communications for Cigna Corporation, where he worked for 15 years. He is now a fellow at the Center for Media and Democracy.

http://news.newamericamedia.org/news/view_article.html?article_id=33655d70ff9cd7509f16bfd2bfbafa9f [newamericamedia.org]

Politicians on Capitol Hill have no trouble with committees that decide the fate of American lives. What they have a problem with is losing corporate donors. Private medical insurance agencies have a lot of lobbyists on the payroll.

Truthfully, the availability of a public option will ultimately save taxpayers money. We already foot the bill with higher hospital expenses and taxes when the poor have to wait until the last minute to receive care. When there's a public clinic that requires virtually no money to visit, people will get more effective and less expensive care earlier. Many of America's lower middle class will then opt out of the ridiculously expensive plans, so they can send their kids to college, or move to a safer neighborhood, or whatever. This will cut into the bottom line of insurance corporations, which is why they are fighting it so bitterly.

And the rich won't see anything change. They'll always pay for private "cadillac" plans, just like they do in Germany and England. They just don't want to lose profits in the insurance companies that they own, or - God forbid - have to pay the same tax rates that they did ten or fifteen years ago.

Re:Government Committees, I need more please (1)

toadlife (301863) | more than 4 years ago | (#31562714)

We should.

Less people would die.

Slylandro probe (3, Funny)

Kev Vance (833) | more than 4 years ago | (#31562270)

Is anyone else reminded of Star Control 2? The "peaceful" Slylandro probe... which was misconfigured with bad priorities.

Captain: Your probe DOES destroy ships and I can prove it!
Slylandro: No! It cannot! It is not programmed for hostile behavior! What is your reasoning?!
Captain: Think about what a probe does when it meets a ship.
Slylandro: Space ships are the probe's highest priority because we want more than anything to make friendly contact with alien races.
Captain: Think about a probe's Replication behavior.
Slylandro: The probe seeks raw materials, and processes them in preparation for Replication.
Captain: Think about the effect of changing the replication behavior's priority.
Slylandro: The answer is simple... it would spend more of its time seeking raw materials for its replication process. So what?
Captain: Now, what will it do to a ship, given that its Replication priority is set to maximum?
Slylandro: I don't see what you are getting at, but I'll play along with you.
Slylandro: Like I said, alien ships are THE top priority target. Once a probe scanned a ship, it would instantly move toward it. Then, when it got to the ship, it would initiate communication automatically. When communications were terminated, a new behavior would be selected, and...
Slylandro: Uh-oh.
Slylandro: A new behavior would be selected, and since the Replication setting was set to maximum the probe wouldn't get time to pick a new target... it would use the current target--the ship--for raw Replication materials. It would process the ship, break it into component compounds with electrical discharges.
Slylandro: Oh no! what have we done? Traveller! You must tell us what we can do! How can we stop the probes from destroying all life in the galaxy?!

Lie (1)

fyoder (857358) | more than 4 years ago | (#31562274)

Good to know. If you're in the UK and you ever have to make an emergency response for someone who has fallen down some stairs, if it looks serious then lie. Not sure what though. Perhaps fallen down stairs into pool of crocodiles, that sounds pretty serious.

Re:Lie (2, Insightful)

bcmm (768152) | more than 4 years ago | (#31562286)

The whole point of the article is that the logical failure in the system would cause it to consider the crocodiles basically harmless because the fall was greater than six feet.

Re:Lie (1)

MichaelSmith (789609) | more than 4 years ago | (#31562672)

If you tell the emergency dispatcher that some property was damaged by the person falling head first down the stairs they will send the police right out to arrest them, so maybe they will get some medical attention that way.

here's my beef (3, Insightful)

timmarhy (659436) | more than 4 years ago | (#31562298)

Shouldn't the 911 operator taking the call be well trained enough to know what's life threatening and whats not? this culture of "the computer will do the thinking for us now" needs to stop.

Re:here's my beef (0, Offtopic)

Mr. Underbridge (666784) | more than 4 years ago | (#31562358)

Shouldn't the 911 operator taking the call be well trained enough to know what's life threatening and whats not?

Um, no. As a wise man once said,

So get up, get, get get down

911 is a joke in yo town

Get up, get, get, get down

Late 911 wears the late crown

Yeah BOYYYYYYEEEEE!

Re:here's my beef (0)

Loomismeister (1589505) | more than 4 years ago | (#31562410)

...No.

Re:here's my beef (0, Flamebait)

timmarhy (659436) | more than 4 years ago | (#31562620)

No what? no you don't have a brain, no you don't agree, no you don't have an opinion?

try making an actual post next time.

Re:here's my beef (1)

jo_ham (604554) | more than 4 years ago | (#31562498)

Yes, they are - and they can override the automatic priority set by the computer based on the information they receive and their own judgement. They also will stay on the line and talk a caller through vital life saving steps while the ambulance is on its way. They are remarkable people, far from the "computer says noooooo" drones that your "culture" seems to suggest.

Of course, they are human and sometimes make mistakes, or are sometimes sub-standard at their jobs, but the vast, vast majority are a credit to their profession.

Re:here's my beef (1)

timmarhy (659436) | more than 4 years ago | (#31562608)

so why is it a problem that the computer had a bug in it's logic? or is this just more wozerism from online meia?

Re:here's my beef (1)

jo_ham (604554) | more than 4 years ago | (#31562754)

Right wing newspaper, 1 year old event (now fixed with update to software and training), election year in UK, governing left wing party in power.

Pretty much covers it.

Re:here's my beef (2, Insightful)

DaveV1.0 (203135) | more than 4 years ago | (#31562676)

What kind of mad skills and knowledge are you expecting of a person being paid, on average, less than US$16.00 per hour?

Will you expect them to be able to diagnose illness and injury over the phone? A medical degree?

What happens if the dispatcher gets it wrong?

May have... (1)

Aladrin (926209) | more than 4 years ago | (#31562344)

May have killed hundreds...

May also have killed nobody.

How sensational!

Re:May have... (4, Interesting)

jo_ham (604554) | more than 4 years ago | (#31562538)

The actual event in question happened a year ago. Given the recent news in the USA - something to do with some sort of bill about healthcare, and the imminent UK general election, I find the timing from a right wing newspaper here in the UK to be highly sensational - especially since the issue has been corrected in the new version of the software, that was released and rolled out last year.

0118 9998 8199 9119 725 3 (4, Funny)

Anonymous Coward | more than 4 years ago | (#31562382)

At least the Brits can be credited for the genius of their new number and catchy jingle. Oh one one eight, nine nine nine--eight eight one nine nine, nine one one nine seven two five! .... three.

Re:0118 9998 8199 9119 725 3 (0)

Anonymous Coward | more than 4 years ago | (#31562666)

How can this get modded troll?!?

http://www.youtube.com/watch?v=5SEm9ynRyeg

Re:0118 9998 8199 9119 725 3 (1)

MichaelSmith (789609) | more than 4 years ago | (#31562680)

112

Why does fall distance matter so much? (0)

DrBuzzo (913503) | more than 4 years ago | (#31562524)

WTF! They determine urgency based on the total distance someone falls? So a person who falls eight feet is automatically considered urgent, even if they landed on their feet and their only symptom is some swelling in their ankle, where as a person who falls four feet and lands on a metal spike which goes directly into their eyeball is a less serious situation?

Believe it or not, I have tripped and fallen down a full flight of stairs and ended up with only a few bruises but I know people who fell off of a stool and broke bones.

Determining the seriousness of an incident has absolutely nothing to do with the height someone has fallen - none.

It seems a typical British call would be like this
"Yes, my friend just fell from a ladder and..."
"Okay, how tall was the ladder"
"Uh.. well he only went down about five feet, but he landed on his head on a cement floor and he's unconscious. He's gurgling up blood.."
"Okay well we're going to consider this a low priority.."
"But he's now going into some kind of convulsions. Oh my god, there's blood coming out of his eyes..."
"Sir, listen, a four foot fall is no reason for concern. We have many other calls to get to. A man just fell off of a one story roof and we think he may have dislocated his knee. There are more important calls to attend to. Just tell your friend not to be such a pansy over such a short fall"


Okay, I have an idea. If you call 911, the problem should be assumed to be a life-critical emergency which emergency services need to get to as fast as is reasonably possible. If its not a life critical, time sensitive emergency, don't call 9-1-1, or 9-9-9 or whatever the emergency number might be!

Re:Why does fall distance matter so much? (1)

0123456 (636235) | more than 4 years ago | (#31562602)

If its not a life critical, time sensitive emergency, don't call 9-1-1, or 9-9-9 or whatever the emergency number might be!

Sadly, you're assuming at least a semblance of rationality in a country where people will call 9-9-9 for an ambulance because they're too lazy to walk across the road to the hospital, or because they're drunk and want a ride home (read some of the British paramedics' blogs for even better stories).

That's what happens when you promise everyone 'free' healthcare... if it's free, why would you bother to walk or pay for a taxi?

Re:Why does fall distance matter so much? (2, Insightful)

pipedwho (1174327) | more than 4 years ago | (#31562752)

The ambulance will only take you to the hospital. If the trip was deemed unnecessary and avoidable (or under false pretences), then you'll receive a sizeable invoice in the mail.

'Free' healthcare is not the bogeyman you think it is. Just because you don't become forever crushed by unrecoverable debt doesn't mean it's a free-for-all wanton orgy of people abusing the system.

Re:Why does fall distance matter so much? (1)

AVryhof (142320) | more than 4 years ago | (#31562694)

I would imagine that a call wouldn't be made if the fall didn't do much harm.

For example, I have fallen off a roof into a snow bank and was unharmed. No ambulance was called.

However, I imagine that if I had fallen and wasn't moving it would have been serious.

As with anything, initial common sense needs to be exercised. It's usually obvious when there is no harm, and often less obvious when there is more harm.

Re:Why does fall distance matter so much? (1)

DaveV1.0 (203135) | more than 4 years ago | (#31562736)

Believe it or not, I have tripped and fallen down a full flight of stairs and ended up with only a few bruises but I know people who fell off of a stool and broke bones.

It is the distance traveled through the air to impact with the ground that matters. Falling down stairs does not count as a 6 foot fall. You are rolling down the steps with maybe a 2 foot fall. Falling off a stool is a 3+ foot fall.

If you fall 6 feet or more, you are likely to have serious head injury or broken bones. Remember, when one falls, one will most likely land on one's back and that means probably head impact.

Order of Operations (2, Insightful)

Vexo (825223) | more than 4 years ago | (#31562526)

Besides the questionable decision regarding the severity of a 6 foot fall, the flaw here seems to be the order in which the conditions were evaluated when determining which category should be assigned. It sounds like when they made the modification, they introduced a bug where a 6+ foot fall would force the call into category B, ignoring other serious condition entries that should have forced it into category A by themselves.

mo3 down (-1, Troll)

Anonymous Coward | more than 4 years ago | (#31562594)

More evil than alternative? (1)

moteyalpha (1228680) | more than 4 years ago | (#31562660)

It seems that what is lacking is the ratio ( deaths in mode X / deaths in mode Y ). So if they change it to category A and something else becomes category B by falling off the end, what death toll does that have and do they even know?

Those responsible have been sacked... (2, Funny)

Alpha232 (922118) | more than 4 years ago | (#31562792)

How could such an audience miss this opportunity to quote Python (Monty)!

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